Personal Information

*First Name:

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*Email Address:

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*Best Phone # to Call You?

*Address 1:

Address 2:

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We will contact you to go over the full details of your membership. Please leave us any requests or notes about the benefits included with your membership level - like your dining preferences and any other requests or information. MAKE SURE YOU CHOOSE THE CORRECT LEVEL

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We can also take Stock Donations – Information as follows;
1) Receiving institution account number – PH-01318.
2) Account title/registration – Park City Performances DBA The Egyptian Theatre.
3) Contact name – Gregory Golding/Laureen Brandin.
4) Telephone – 435-252-3825.
5) Name of Receiving DTC Brokerage Firm – UBS Financial Services, Inc.
6) DTC Number - 0221.
Please notify us if you are donating stock! We can accept donations from Qualified IRA's and Donations can be split over two years - 2018 and 2019.

Fee

Type

Fee

Spotlight Level

$1,500.00

Center Stage Level

$750.00

Producer Level

$3,000.00

Marquee Level

$5,000.00

Encore Level

$10,000.00

Spouse or Partner Information

Name of Spouse or Partner

Spouse or Partner Email

Spouse or Partner Phone

How do you want your Name(s) Listed? Example: "Jill and John P. Haraoh"

Support our Capital Campaign for Egyptian Studios?

Item

Qty.

Max Limit

Price

Save Our Space Contribution -Seats

(20 available)

THEATRE SEAT NAME PLATES - Black Box Theatre

4

$750.00 each

Save Our Space Contribution - Video Screen

(2 available)

Photo and Name on scroll - Video Screen in Lobby of the new Egyptian Studios

MAJOR CONTRIBUTORS

Payment

Payment Method

Payment Summary

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